Abstract
Objectives
Given persistent racial/ethnic disparities in unintended pregnancies, this study aims
to understand factors associated with emergency contraception (EC) use among non-Hispanic
White, non-Hispanic Black, and Hispanic women.
Methods
This study used a nationally representative sample of 1,990 women of reproductive
age in the United States who participated in the 2016 Survey of Family Planning and
Women's Lives. Logistic regressions were estimated to assess the association of sexual/pregnancy
history, attitudes toward pregnancy, attitudes toward contraception, awareness and
beliefs about EC, and source of information regarding contraception with ever using
EC.
Results
After adjusting for demographic characteristics, we found no significant differences
in ever using EC by race/ethnicity. Among non-Hispanic White women, those who used
barrier methods of contraception, reported a previous unplanned pregnancy, reported
having heard some or a lot about EC, and believed that EC is somewhat to very effective
had higher odds of EC use. Among non-Hispanic Black women, those who reported a previous
unplanned pregnancy and believed that EC was somewhat to very effective had higher
odds of EC use. Among Hispanic women, those who reported using long-acting reversible
contraceptives, having recent male sexual partners, and believing that EC is both
somewhat to very safe and effective had higher odds of EC use.
Conclusions
Awareness and beliefs about safety and effectiveness are modifiable factors that may
influence EC use. Population-level interventions can focus on improving awareness
and understanding of the safety and effectiveness of EC.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Women's Health IssuesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Knowledge and awareness of emergency contraception in adolescents.Journal of Pediatric and Adolescent Gynecology. 2010; 23: 273-278
- Emergency contraception.(Available:)https://www.acog.org/Patients/FAQs/Emergency-Contraception#differentDate: 2018Date accessed: August 1, 2019
- Who is using emergency contraception? Awareness and use of emergency contraception among California women and teens.Women’s Health Issues. 2008; 18: 360-368
- Racial/ethnic differences in contraceptive preferences, beliefs, and self-efficacy among women veterans.American Journal of Obstetrics and Gynecology. 2017; 216: 504.e1-504.e10
- Developing culturally relevant educational materials about emergency contraception.Journal of Health Communication. 2010; 15: 502-515
- Exploring young adults’ contraceptive knowledge and attitudes: disparities by race/ethnicity and age.Womens Health Issues. 2014; 24: e281-e289
- Neighborhood poverty, aspirations and expectations, and initiation of sex.Journal of Adolescent Health. 2010; 47: 399-406
- Use of emergency contraception among women aged 15-44: United States, 2006-2010.NCHS Data Brief. 2013; 112: 1-8
- Contraceptive counseling: Best practices to ensure quality communication and enable effective contraceptive use.Clinical Obstetrics and Gynecology. 2014; 57: 659-673
- Racial/ethnic disparities in contraceptive use: Variation by age and women’s reproductive experiences.American Journal of Obstetrics and Gynecology. 2014; 210: 526.e1-526.e9
- Missed opportunities: Teenagers and emergency contraception.Archives of Pediatrics & Adolescent Medicine. 1998; 152: 727-733
- Declines in unintended pregnancy in the United States, 2008–2011.New England Journal of Medicine. 2016; 374: 843-852
- Factors associated with contraceptive use and nonuse, United States, 2004.Perspectives on Sexual and Reproductive Health. 2007; 39: 90-99
- Young adults’ contraceptive knowledge, norms and attitudes: Associations with risk of unintended pregnancy.Perspectives on Sexual and Reproductive Health. 2012; 44: 107-116
- Unintended childbearing and knowledge of emergency contraception in a population-based survey of postpartum women.Maternal and Child Health Journal. 2008; 12: 332-341
- Emergency contraception.(Available:)https://www.guttmacher.org/state-policy/explore/emergency-contraceptionDate: 2018Date accessed: August 1, 2019
- Pregnancy ambivalence and contraceptive use among young adults in the United States.Perspectives on Sexual and Reproductive Health. 2012; 44: 236-243
- Emergency contraception.(Available:)https://www.kff.org/womens-health-policy/fact-sheet/emergency-contraception/Date: 2016Date accessed: August 1, 2019
- Counseling about and use of emergency contraception in the United States.Perspectives on Sexual and Reproductive Health. 2008; 40: 81-86
- Emergency contraception use and counseling after changes in United States prescription status.Fertility and Sterility. 2011; 95: 2578-2581
- Learning in social networks and contraceptive choice.Demography. 1997; 34: 369-383
- Likelihood of emergency contraception use among African-American women at risk of adverse birth outcomes.Maternal and Child Health Journal. 2014; 18: 1190-1195
- Assessing attitudes about emergency contraception among urban, minority adolescent girls: An in-depth interview study.Pediatrics. 2008; 122: e395-e401https://doi.org/10.1542/peds.2008-0009
- Use of contraception in the United States: 1982-2008.Vital Health Statistics. 2010; 23: 1-44
- Emergency contraception.(Available:)
- Characteristics of women who sought emergency contraception at a university-based women’s health clinic.American Journal of Obstetrics and Gynecology. 2009; 201: 22.e1-22.e7
- Emergency contraception counseling in a retail pharmacy setting: a pilot study.Journal of Pharmacy Practice. 2015; 28: 261-265
- Beyond access: acceptability, use and nonuse of emergency contraception among young women.American Journal of Obstetrics & Gynecology. 2007; 196: 29.e1
- Do racial and ethnic differences in contraceptive attitudes and knowledge explain disparities in method use?.Perspectives on Sexual and Reproductive Health. 2012; 44: 150-158
- The Survey of Family Planning and Women’s Lives: Methodology.Urban Institute, Washington, DC2016 (Available:)https://www.urban.org/sites/default/files/survey-of-family-planning-and-womens-lives-methodology-2016_0.pdfDate accessed: August 1, 2019
- Stata statistical software: Release 12.StataCorp LP, College Station, TX2011
- Current population survey. [Data file].(Available:)
- Characteristics associated with emergency contraception use by family planning patients: A prospective cohort study.Perspectives on Sexual and Reproductive Health. 2007; 39: 158-166
- Contraceptive nonuse among US women at risk for unplanned pregnancy.Contraception. 2008; 78: 284-289
- The role of the social network in contraceptive decision-making among young, African American and Latina Women.Journal of Adolescent Health. 2010; 47: 374-380
Biography
Caroline Heller, MPH, is a Data Analyst in the Office of Community and Population Health at Montefiore Medical Center. Her research focuses on health outcomes for vulnerable populations, with a focus on women's health and racial/ethnic disparities.
Biography
Krista M. Perreira, PhD, is a Professor of Social Medicine at the University of North Carolina School of Medicine. Her research focus on racial/ethnic health disparities as well as policies and practices that affect the well-being of immigrant populations.
Biography
Adele Shartzer, PhD, is a research associate in the Health Policy Center at the Urban Institute, where her work focuses on health coverage, access to care, and the health care delivery system.
Biography
Emily M. Johnston, PhD, is a research associate in the Health Policy Center at the Urban Institute. Her research focuses on access to health care, particularly the effects of state and federal policies on the health and well-being of vulnerable populations.
Biography
Brigette Courtot, MPH, is a senior research associate in the Health Policy Center at the Urban Institute. Her work focuses on reproductive health care, public coverage programs, maternal and child health, and access to care for underserved populations.
Article info
Publication history
Published online: February 20, 2019
Accepted:
January 11,
2019
Received in revised form:
January 8,
2019
Received:
June 15,
2018
Footnotes
Disclosures: The authors declare no conflicts of interest.
Identification
Copyright
© 2019 Jacobs Institute of Women's Health. Published by Elsevier Inc.
